Factores asociados al absentismo en las consultas externas de otorrinolaringología a partir de una revisión sistemática
No-show rates in Otolaryngology
Resumen
Introducción y objetivo: El absentismo en consultas externas representa un problema relevante para los sistemas sanitarios, al comprometer la eficiencia asistencial, incrementar las listas de espera y limitar el acceso a la atención. El objetivo de esta revisión sistemática fue analizar la evidencia disponible sobre los factores asociados al absentismo en las consultas externas de Otorrinolaringología (ORL). Métodos: Se realizó una revisión sistemática con síntesis narrativa siguiendo las directrices PRISMA 2020. Se llevó a cabo una búsqueda estructurada en MEDLINE/PubMed y Web of Science hasta marzo de 2026. Se incluyeron estudios originales realizados en consultas externas presenciales de ORL que evaluaran el absentismo o sus factores asociados en población adulta o pediátrica. El riesgo de sesgo de los estudios incluidos se evaluó mediante las herramientas de evaluación crítica del Joanna Briggs Institute (JBI), seleccionadas según el diseño de cada estudio. La síntesis de los resultados se realizó mediante un enfoque narrativo temático, agrupando los factores en dominios sociodemográficos, organizativos y clínicos. La revisión fue registrada en PROSPERO (CRD420261286369). Resultados: Se incluyeron 20 estudios, mayoritariamente realizados en centros universitarios. Las tasas de absentismo oscilaron entre el 8 % y el 40 %. Los factores más consistentemente asociados con mayor absentismo fueron la menor edad, el bajo nivel socioeconómico y las demoras prolongadas en la obtención de la cita. Asimismo, la ausencia de sistemas de recordatorio se asoció con una mayor probabilidad de absentismo. Conclusiones: El absentismo en las consultas externas de ORL es un fenómeno frecuente y multifactorial. Los factores sociodemográficos y organizativos muestran asociaciones más consistentes que los factores clínicos. Intervenciones organizativas como la reducción de los tiempos de espera y la implementación de sistemas de recordatorio podrían asociarse con una reducción del absentismo. No obstante, la naturaleza observacional y la heterogeneidad de los estudios limitan la capacidad para establecer relaciones causales y la generalización de los resultados.
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Jabalera Mesa ML, Morales Asencio JM, Rivas Ruiz F, Porras González MH. Analysis of economic cost of missed outpatient appointments. Rev Calid Asist. 2017;32(4):194-9. https://doi.org/10.1016/j.cali.2017.01.004. PMID: 28476506.
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Negro Álvarez JM, Guerrero Fernández M, Campuzano López FJ, Bernal Fernández T, Pellicer F, Murcia Vivancos MC, et al. Incumplimiento a citas concertadas en pacientes de una consulta de alergología. Alergol Inmunol Clin. 2002;295-302.
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Agarwal P, Nathan AS, Jaleel Z, Levi JR. Factors contributing to missed appointments in a pediatric otolaryngology clinic. Laryngoscope. 2022;132(4):895-900. https://doi.org/10.1002/lary.29841. PMID: 34427327.
Ahmadi O, Maher W, White J. Non-attendance at an out-patient otolaryngology and head and neck clinic in New Zealand: impact of coronavirus disease 2019, and demographic, clinical and environmental factors. J Laryngol Otol. 2021;135(6):533-8. https://doi.org/10.1017/S0022215121001092. PMID: 33988101.
Fattahi CB, Purkayastha A, Roychowdhury P, Kamil SH, Sobin L. Impacts of health insurance on tympanostomy tube outcomes in the pediatric population. Int J Pediatr Otorhinolaryngol. 2023;173:111715. https://doi.org/10.1016/j.ijporl.2023.111715. PMID: 37659379.
Fiorillo CE, Hughes AL, I-Chen C, Westgate PM, Gal TJ, Bush ML, et al. Factors associated with patient no-show rates in an academic otolaryngology practice. Laryngoscope. 2018;128(3):626-31. https://doi.org/10.1002/lary.26816. PMID: 28815608. PMCID: PMC5814324.
Huang Z, Ashraf M, Gordish-Dressman H, Mudd P. The financial impact of clinic no-show rates in an academic pediatric otolaryngology practice. Am J Otolaryngol. 2017;38(2):127-9. https://doi.org/10.1016/j.amjoto.2016.11.004. PMID: 27913067.
Hunter BN, Cardon B, Oakley GM, Sharma A, Crosby DL. Factors associated with patient nonattendance in rhinology clinics. Am J Rhinol Allergy. 2019;33(3):317-22. https://doi.org/10.1177/1945892419826247. PMID: 30693801.
Husman T, Miraftab-Salo O, Ilan A, Brodie S, Paciorek A, Durr ML, et al. Predictors of no-show in a safety-net otolaryngology clinic: a repeated measures approach. Laryngoscope. 2025;135(9):3123-3133. https://doi.org/10.1002/lary.32150. PMID: 40135762. PMCID: PMC12371846.
Kasem AA, Althobaiti TS, Al-Jeaid DAS, Al-Osaimi SM. An analysis of causes behind missed scheduled appointments at outpatient ENT clinics. Egypt J Otolaryngol. 2015;31(1):1-3. https://doi.org/10.4103/1012-5574.152701.
Miller AJ, Chae E, Peterson E, Ko AB. Predictors of repeated «no-showing»to clinic appointments. Am J Otolaryngol. 2015;36(3):411-4. https://doi.org/10.1016/j.amjoto.2015.01.017. PMID: 25672853.
Naimi B, Agarwal P, Ma H, Levi JR. Association between no-show rates and interpreter use in a pediatric otolaryngology clinic. Int J Pediatr Otorhinolaryngol. 2023;172:111663. https://doi.org/10.1016/j.ijporl.2023.111663. PMID: 37506576.
Sunkara Y, Ulualp SO, Robinson K, Lenes-Voit F, Liu CC, Mitchell RB. No-shows in a tertiary care pediatric otolaryngology clinic: predictors and impact on provider productivity. Laryngoscope Investig Otolaryngol. 2025;10(1):e70097. https://doi.org/10.1002/lio2.70097. PMID: 39925632. PMCID: PMC11806372.
Velu P, Wilson C, Kariveda RR, Weber PC, Levi JR. Factors associated with follow-up appointment attendance in adults with sensorineural hearing loss. Otol Neurotol. 2025;46(7):759-765. https://doi.org/10.1097/MAO.0000000000004530. PMID: 40423686.
Wilson CA, Jamil TL, Velu PS, Levi JR. Patient factors associated with missed otolaryngology appointments at an urban safety-net hospital. Laryngoscope. 2024;134(9):4003-10. https://doi.org/10.1002/lary.31401. PMID: 38602281.
Yuhan BT, Yasuda MA, Joshi R, Charous S, Hurtuk A. No-show rates in an academic otolaryngology practice before and during the COVID-19 pandemic. Cureus. 2024;16(2):e54015. https://doi.org/10.7759/cureus.54015. PMID: 38476808. PMCID: PMC10929764.
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Bahammam FA, Tolley N, Kuchai R, Benjamin E, Rollin M. Analyzing factors and reasons behind nonattendance of ENT patients: clinical audit. Ear Nose Throat J. 2024;1455613241283798. https://doi.org/10.1177/01455613241283798. PMID: 39374084.
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Fonseca E, Vázquez P, Mata P, Pita S, Luisa Muiño M. Estudio de la inasistencia a las citaciones en consulta en un servicio de dermatología. Piel. 2001;16(10):485-9. https://doi.org/10.1016/S0213-9251(01)72509-9.
Negro Álvarez JM, Guerrero Fernández M, Campuzano López FJ, Bernal Fernández T, Pellicer F, Murcia Vivancos MC, et al. Incumplimiento a citas concertadas en pacientes de una consulta de alergología. Alergol Inmunol Clin. 2002;295-302.
Hernández-García I, Chaure-Pardos A, Moliner-Lahoz J, Prieto-Andrés P, Mareca-Doñate R, Giménez-Júlvez T, et al. Absentismo y factores asociados, en las citas programadas de una consulta externa de Medicina Preventiva. J Healthc Qual Res. 2018;33(2):82-7. https://doi.org/10.1016/j.cali.2017.12.006. PMID: 29530605.
Zebolsky AL, Gallo N, Clarke T, May JA, Dedhia RD, et al. Risk factors for missed follow-up appointments among facial trauma patients. Facial Plast Surg. 2025;41(3):319-26. https://doi.org/10.1055/a-2325-5425. PMID: 38744423.
Baptista SCPD, Juliani CMCM, Lima SGSE, Martin LB, Silva KAB, Cirne MR. Patient absenteeism in outpatient consultations: an integrative literature review. Rev Esc Enferm USP. 2021;55:e20200380. https://doi.org/10.1590/1980-220X-REEUSP-2020-0380. PMID: 34423800.
Alcolea Guerrero M, Gorgemans S. Absentismo de pacientes citados en las consultas de Atención Especializada en el Consorcio Aragonés Sanitario de Alta Resolución: repercusiones económicas y demoras. Rev Adm Sanit Siglo XXI. 2009;7(4):715-28.
Dantas LF, Fleck JL, Cyrino Oliveira FL, Hamacher S. No-shows in appointment scheduling: a systematic literature review. Health Policy. 2018;122(4):412-21. https://doi.org/10.1016/j.healthpol.2018.02.002. PMID: 29482948.
Stanisce L, Ahmad N, Solomon DH, Kolia N, Garcia LD, Spalla TC, et al. Improving outpatient follow-up rates for new in-hospital consults. Laryngoscope. 2023;133(10):2540-5. https://doi.org/10.1002/lary.30519. PMID: 36511340.
Cui AZ, Goyal SS, Okigbo AA, Govani VN, Gillman GS, Sridharan SS, et al. Predictors of loss to follow-up after operative facial trauma. Laryngoscope. 25 dic 2025. https://doi.org/10.1002/lary.70330. PMID: 41449844.
Neal RD, Hussain-Gambles M, Allgar VL, Lawlor DA, Dempsey O. Reasons for and consequences of missed appointments in general practice in the UK: questionnaire survey and prospective review of medical records. BMC Fam Pract. 2005;6:47. https://doi.org/10.1186/1471-2296-6-47. PMID: 16274481. PMCID: PMC1291364.
Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372:n160. https://doi.org/10.1136/bmj.n160. PMID: 33781993. PMCID: PMC8005925.
JBI Manual for Evidence Synthesis [Internet]. Adelaide: JBI; [citado 22 dic 2025]. Disponible en: https://jbi-global-wiki.refined.site/space/MANUAL.
Adigwu Y, Osterbauer B, Hochstim C. Disparities in access to pediatric otolaryngology care during the COVID-19 pandemic. Ann Otol Rhinol Laryngol. 2022;131(9):971-8. https://doi.org/10.1177/00034894211048790. PMID: 34622688. PMCID: PMC8503931.
Adkins D, Rojas-Ramirez MV, Shanker A, Burruss CP, Mirsky B, Westgate P, et al. Factors associated with no-show rates in a pediatric audiology clinic. Otol Neurotol. 2023;44(9):e648-52. https://doi.org/10.1097/MAO.0000000000003997. PMID: 37590879. PMCID: PMC10529984.
Agarwal P, Nathan AS, Jaleel Z, Levi JR. Factors contributing to missed appointments in a pediatric otolaryngology clinic. Laryngoscope. 2022;132(4):895-900. https://doi.org/10.1002/lary.29841. PMID: 34427327.
Ahmadi O, Maher W, White J. Non-attendance at an out-patient otolaryngology and head and neck clinic in New Zealand: impact of coronavirus disease 2019, and demographic, clinical and environmental factors. J Laryngol Otol. 2021;135(6):533-8. https://doi.org/10.1017/S0022215121001092. PMID: 33988101.
Fattahi CB, Purkayastha A, Roychowdhury P, Kamil SH, Sobin L. Impacts of health insurance on tympanostomy tube outcomes in the pediatric population. Int J Pediatr Otorhinolaryngol. 2023;173:111715. https://doi.org/10.1016/j.ijporl.2023.111715. PMID: 37659379.
Fiorillo CE, Hughes AL, I-Chen C, Westgate PM, Gal TJ, Bush ML, et al. Factors associated with patient no-show rates in an academic otolaryngology practice. Laryngoscope. 2018;128(3):626-31. https://doi.org/10.1002/lary.26816. PMID: 28815608. PMCID: PMC5814324.
Huang Z, Ashraf M, Gordish-Dressman H, Mudd P. The financial impact of clinic no-show rates in an academic pediatric otolaryngology practice. Am J Otolaryngol. 2017;38(2):127-9. https://doi.org/10.1016/j.amjoto.2016.11.004. PMID: 27913067.
Hunter BN, Cardon B, Oakley GM, Sharma A, Crosby DL. Factors associated with patient nonattendance in rhinology clinics. Am J Rhinol Allergy. 2019;33(3):317-22. https://doi.org/10.1177/1945892419826247. PMID: 30693801.
Husman T, Miraftab-Salo O, Ilan A, Brodie S, Paciorek A, Durr ML, et al. Predictors of no-show in a safety-net otolaryngology clinic: a repeated measures approach. Laryngoscope. 2025;135(9):3123-3133. https://doi.org/10.1002/lary.32150. PMID: 40135762. PMCID: PMC12371846.
Kasem AA, Althobaiti TS, Al-Jeaid DAS, Al-Osaimi SM. An analysis of causes behind missed scheduled appointments at outpatient ENT clinics. Egypt J Otolaryngol. 2015;31(1):1-3. https://doi.org/10.4103/1012-5574.152701.
Miller AJ, Chae E, Peterson E, Ko AB. Predictors of repeated «no-showing»to clinic appointments. Am J Otolaryngol. 2015;36(3):411-4. https://doi.org/10.1016/j.amjoto.2015.01.017. PMID: 25672853.
Naimi B, Agarwal P, Ma H, Levi JR. Association between no-show rates and interpreter use in a pediatric otolaryngology clinic. Int J Pediatr Otorhinolaryngol. 2023;172:111663. https://doi.org/10.1016/j.ijporl.2023.111663. PMID: 37506576.
Sunkara Y, Ulualp SO, Robinson K, Lenes-Voit F, Liu CC, Mitchell RB. No-shows in a tertiary care pediatric otolaryngology clinic: predictors and impact on provider productivity. Laryngoscope Investig Otolaryngol. 2025;10(1):e70097. https://doi.org/10.1002/lio2.70097. PMID: 39925632. PMCID: PMC11806372.
Velu P, Wilson C, Kariveda RR, Weber PC, Levi JR. Factors associated with follow-up appointment attendance in adults with sensorineural hearing loss. Otol Neurotol. 2025;46(7):759-765. https://doi.org/10.1097/MAO.0000000000004530. PMID: 40423686.
Wilson CA, Jamil TL, Velu PS, Levi JR. Patient factors associated with missed otolaryngology appointments at an urban safety-net hospital. Laryngoscope. 2024;134(9):4003-10. https://doi.org/10.1002/lary.31401. PMID: 38602281.
Yuhan BT, Yasuda MA, Joshi R, Charous S, Hurtuk A. No-show rates in an academic otolaryngology practice before and during the COVID-19 pandemic. Cureus. 2024;16(2):e54015. https://doi.org/10.7759/cureus.54015. PMID: 38476808. PMCID: PMC10929764.
Zirkle MS, McNelles LR. Nonattendance at a hospital-based otolaryngology clinic: a preliminary analysis within a universal healthcare system. Ear Nose Throat J. 2011;90(8):E32-34. https://doi.org/10.1177/014556131109000822. PMID: 21229509.
Bahammam FA, Tolley N, Kuchai R, Benjamin E, Rollin M. Analyzing factors and reasons behind nonattendance of ENT patients: clinical audit. Ear Nose Throat J. 2024;1455613241283798. https://doi.org/10.1177/01455613241283798. PMID: 39374084.
Comer BT, Harris LE, Fiorillo CE, Gal TJ, Hughes A. No-show rates in employed otolaryngology practice. Ear Nose Throat J. 2019;145561319893157. https://doi.org/10.1177/0145561319893157. PMID: 31838919.
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